Lazarus Lisa, Patel Sheetal, Shaw Ashley, Leblanc Sean, Lalonde Christine, Hladio Manisha, Mandryk Kira, Horvath Cynthia, Petrcich William, Kendall Claire, Tyndall Mark W
Ottawa Hospital Research Institute, Ottawa, Canada.
PROUD Community Advisory Committee, Ottawa, Canada.
PLoS One. 2016 Dec 2;11(12):e0166942. doi: 10.1371/journal.pone.0166942. eCollection 2016.
HIV prevalence among people who inject drugs (PWID) in Ottawa is estimated at about 10%. The successful integration of peers into outreach efforts and wider access to HIV point-of-care testing (POCT) create opportunities to explore the role of peers in providing HIV testing. The PROUD study, in partnership with Ottawa Public Health (OPH), sought to develop a model for community-based peer-administered HIV POCT.
PROUD draws on community-based participatory research methods to better understand the HIV risk environment of people who use drugs in Ottawa. From March-October 2013, 593 people who reported injecting drugs or smoking crack cocaine were enrolled through street-based recruitment. Trained peer or medical student researchers administered a quantitative survey and offered an HIV POCT (bioLytical INSTI test) to participants who did not self-report as HIV positive.
550 (92.7%) of the 593 participants were offered a POCT, of which 458 (83.3%) consented to testing. Of those participants, 74 (16.2%) had never been tested for HIV. There was no difference in uptake between testing offered by a peer versus a non-peer interviewer (OR = 1.05; 95% CI = 0.67-1.66). Despite testing those at high risk for HIV, only one new reactive test was identified.
The findings from PROUD demonstrate high uptake of community-based HIV POCT. Peers were able to successfully provide HIV POCT and reach participants who had not previously been tested for HIV. Community-based and peer testing models provide important insights on ways to scale-up HIV prevention and testing among people who use drugs.
据估计,渥太华注射吸毒者(PWID)中的艾滋病毒流行率约为10%。同伴成功融入外展工作以及更广泛地获得艾滋病毒即时检测(POCT),为探索同伴在提供艾滋病毒检测方面的作用创造了机会。“自豪”研究与渥太华公共卫生部门(OPH)合作,旨在开发一种基于社区的同伴管理艾滋病毒POCT模式。
“自豪”研究采用基于社区的参与性研究方法,以更好地了解渥太华吸毒者的艾滋病毒风险环境。2013年3月至10月,通过街头招募,登记了593名报告注射毒品或吸食快克可卡因的人。经过培训的同伴或医学生研究人员进行了定量调查,并为未自我报告为艾滋病毒阳性的参与者提供了艾滋病毒POCT(生物分析INSTI检测)。
593名参与者中有550名(92.7%)接受了POCT,其中458名(83.3%)同意检测。在这些参与者中,74名(16.2%)从未接受过艾滋病毒检测。同伴与非同伴访谈者提供的检测接受率没有差异(OR = 1.05;95% CI = 0.67 - 1.66)。尽管对艾滋病毒高危人群进行了检测,但仅发现一例新的反应性检测结果。
“自豪”研究的结果表明,基于社区的艾滋病毒POCT接受率很高。同伴能够成功提供艾滋病毒POCT,并接触到以前未接受过艾滋病毒检测的参与者。基于社区和同伴的检测模式为扩大吸毒者中的艾滋病毒预防和检测方法提供了重要见解。